Chapter 16 & 17
Which of the following would cause the greatest increase in cardiac output?
Increased heart rate and increased stroke volume
medications to treat seizures
Levetriacetam (Keppra), phenytoin (Dilantin), Phenobarbital, Carbamazepine (Tegretol), Valproate (Depakote), Topiramate (Topamax), Clonazepam (Klonopin)
Which of the following blood vessels transports oxygenated blood?
Pulmonary veins
An acute myocardial infarction (AMI) occurs when:
myocardial tissue dies secondary to an absence of oxygen.
A patient with an altered mental status is:
not thinking clearly or is incapable of being aroused.
the principle clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia
usually have an altered mental status or decreased level or consciousness
Defibrillator pads are placed on the patient's chest:
with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.
successful treatment of a stroke depends on whether or not
(thrombolytic therapy) clot-buster therapy is given within 2-3 hours of symptom onset
which of the following patients would most likely demonstrate typical signs of infection or fever? A) an 88-year-old male with chronic renal problems B) a 17-year-old male with depression and anxiety C) a 3-month-old female who was born prematurely D) a 35-year-old female in the later stages of AIDS
17-year-old male with depression and anxiety
A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment?
Absence of a palpable pulse
Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?
Administer the medication sublingually and allow it to dissolve or absorb.
Which of the following is a major difference between angina pectoris and AMI?
Anginal pain typically subsides with rest.
Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?
Aspirin
You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include:
BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation.
Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?
Hypotension and flat jugular veins
which of the following patients would most likely demonstrate typical signs of infection or fever?
a 17-year-old male with depression and anxiety
Common signs and symptoms of a hypertensive emergency include:
a bounding pulse, a severe headache, and dizziness.
status epiliptcus
a condition in which seizures recur every few minutes or last more than 30 minutes
Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?
a rapid heart rate
When caring for a patient with documented hypoglycemia, you should be MOST alert for:
a seizure
A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, and her respirations are 22 breaths/min with adequate depth. The patient does not have prescribed nitroglycerin, but her husband does. You should
administer oxygen, give her 2 (81mg each tablet) chewable aspirin, and assess her further.
a 58-year-old male presents with confusion, right-sided weakness, and slurred speech. as your partner is applying oxygen, it is most important for you to
ask his wife when she noticed symptoms
law enforcement has summoned you to a nightclub, where a 22-year-old female was found unconscious in an adjacent alley. your primary assessment reveals that her respirations are rapid and shallow and her pulse is rapid and weak. she is wearing a medical alert bracelet that identifies her as an epileptic. there is an empty bottle of vodka next to the patient. you should:
assist ventilations, perform a rapid exam, and prepare for immediate transport.
Narrowing of the coronary arteries due to a buildup of fatty deposits is called:
atherosclerosis.
The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:
automaticity
which of the following most accurately describes the cause of an ischemic stoke?
blockage of a cerebral artery
Muscle control and body coordination are controlled by the:
cerebellium
In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest:
delivers high-energy shocks, similar to an AED.
The main legal risk in using the AED is:
failing to deliver a shock when one is needed.
A 29-year-old male complains of a severe headache and nausea that has gradually worsened over the past 12 hours. He is conscious, alert, and oriented and tells you that his physician diagnosed him with migraine headaches. He further tells you that he has taken numerous different medications, but none of them seem to help. His blood pressure is 132/74 mm Hg, his pulse is 110 beats/min and strong, and his respirations are 20 breaths/min and adequate. In addition to high-flow oxygen, further treatment should include:
dimming the lights in the back of the ambulance and transporting without lights and siren.
A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What are her signs and symptoms MOST indicative of?
dissecting aortic aneurysm
the anterior aspect of the cerebrum controls
emotion
Prior to defibrillating a patient with an AED, it is MOST important that you:
ensure that no one is touching the patient.
When obtaining a 12-lead ECG, the patient should be:
in a supine position with legs uncrossed.
The AED is MOST advantageous to the EMT because:
it delivers prompt defibrillation to patients with ventricular fibrillation.
A patient with atherosclerotic heart disease experiences chest pain during exertion because the:
lumen of the coronary artery is narrowed and cannot accommodate increased blood flow.
You arrive at a grocery store shortly after a 35-year-old male stopped seizing. Your assessment reveals that he is confused and incontinent of urine. The patient's girlfriend tells you that he has a history of seizures and takes carbamazepine (Tegretol). When obtaining further medical history from the girlfriend, it is MOST important to:
obtain a description of how the seizure developed
Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:
perform CPR for 2 minutes and reassess.
Status epilepticus is characterized by:
prolonged seizures without a return of consciousness.
A patient who is experiencing aphasia is:
unable to produce or understand speech.
which of the following conditions would most likely affect the entire brain? A) blocked cerebral artery in the frontal lobe B) respiratory failure or cardiopulmonary arrest C) reduced blood supply to the left hemisphere D) ruptured cerebral artery in the occipital lobe
respiratory failure or cardiopulmonary arrest
Deoxygenated blood from the body returns to the
right atrium
which of the following conditions is not a common cause of seizures? A) acute alcohol withdrawal B) severe hypovolemia C) acute hypoglycemia D) poisoning or overdose
severe hypovolemia
The electrical impulse generated by the heart originates in the:
sinoatrial (SA) node.
which of the following clinical signs would be most suggestive of a ruptured cerebral artery?
sudden, severe headache
which of the following clinical signs would be most suggestive of a ruptured cerebral artery? A) unilateral hemiparesis B) nasal discharge of blood C) confusion and weakness D) sudden, severe headache
sudden, severe headache
You respond to a residence for a child who is having a seizure. Upon arrival at the scene, you enter the residence and find the mother holding her child, a 2-year-old male. The child is conscious and crying. According to the mother, the child had been running a high fever and then experienced a seizure that lasted approximately 3 minutes. You should:
transport the child to the hospital and reassure the mother en route.